The authors present material on processes of strategic change in the British National Health Service. In particular, the book focuses on the organizational and managerial response to HIV/AIDS, a health care crisis which became a major public health issue for the NHS in the 1980s. Empirical material is drawn from the response of a number of district health authorities to this epidemic. The authors analyse who drove forward innovation in these localities, how coalitions were formed and how energy was created for change. They also examine the role of ideology. This material should be useful reading for those working in HIV/AIDS management, whether in the health service, local authority or non-statutory sectors. It should also have relevance to managers and students of organizational theory who are interested more broadly in how organizations change.